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Effect of NT 201 (Botulinum Neurotoxin Type A Free of Complexing Proteins) on Sleep-related Breathing Disorders (Snoring)

Primary Purpose

Sleep-Disordered Breathing

Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
NT 201, a Botulinum neurotoxin type A, free of complexing proteins
Sponsored by
Merz Pharmaceuticals GmbH
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Sleep-Disordered Breathing focused on measuring Sleep-related breathing disorders, Snoring

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male and female outpatients of at least 18 years of age.
  2. Patient who understand the nature of the study and provide written informed consent prior to protocol-specific procedures.
  3. Patients suffering from sleep-related breathing disorders for at least 3 months prior to study start and seeking help for their snoring.
  4. Non-REM RDI ≤ 25/h (according to Medicare Criteria) at baseline PSG.
  5. AHI ≤ 10/h at baseline PSG.
  6. Snoring Index ≥ 15 at baseline PSG.

Exclusion Criteria:

  1. Patients with known hypersensitivity to:

    • botulinum neurotoxin type;
    • any of the excipients (human albumin, sucrose).
  2. Patients with upper respiratory tract pathology as assessed by an ear, nose, and throat [ENT] specialist.
  3. Patients with generalized disorders of muscle activity (e.g. myasthenia gravis, Lambert-Eaton syndrome).
  4. Patients with bleeding disorders of any type and/or receiving anticoagulant therapy.
  5. Patients with a profound sleep disorder (pathological number and duration of episodes of hypopnea and apnea), upper airway resistance syndrome [UARS], or obstructive sleep apnea syndrome [OSAS].
  6. Obese patients (BMI ≥ 30).
  7. Presence of concomitant diseases:

    • severe or unstable cardiovascular (e.g. severe angina pectoris, post myocardial infarction and ventricular extra systoles), pulmonary, or endocrine disease; clinically relevant renal or hepatic disease or dysfunction; hematological disorder; any other clinically relevant medical condition that could increase the risk to the study participant;
    • malignant disease of any kind during the previous 5 years except for successfully treated skin (basal or squamous cell) cancer;
    • amyotrophic lateral sclerosis or other diseases which result in peripheral neuromuscular dysfunction;
    • risk of developing an angle closure glaucoma;
    • alcohol, drug, or medication abuse within the past year;
    • severe psychiatric or neurological disorders;
    • acute infections of the pharynx.
  8. Patients likely to need concomitant medication as follows:

    • 4-aminochinolines;
    • aminoglycosides or spectinomycin, or other medical products interfering with neuromuscular transmission, e.g. tubocurarine-type muscle relaxants;
    • daily psychotropic medication;
    • regular intake or onset of hypnotics, e.g. benzodiazepines, chloralhydrate and combinations, barbiturates (except of mild phytotherapeutics, e.g. valerian, hop and combinations);
    • anti-snoring products during the course of the study such as foams, dental devices.
  9. Pregnant or nursing women, or women of childbearing potential who are not using and not willing to continue using a medically reliable method of contraception for the entire study duration, such as oral, injectable, or implantable contraceptives, or intrauterine contraceptive devices, unless they are surgically sterilized/ hysterectomized.
  10. Participation in a clinical study within the last 30 days prior to the start of the study.
  11. Patients who are employees, relative or spouse of the investigator, of other staff of the investigational site or the sponsor or the CRO.
  12. Any donation of germ cells, blood, organs, or bone marrow during the course of the study.
  13. Patients who are expected to be non-compliant and/or not cooperative.
  14. Patients who are not contractually capable.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Active Comparator

    Placebo Comparator

    Arm Label

    Botulinum Toxin Typ A

    Placebo

    Arm Description

    Outcomes

    Primary Outcome Measures

    Comparison of the ratio of snoring time over sleeping time (Snoring Index)

    Secondary Outcome Measures

    Change in ventilation (oral/nasal flow) from V0 to V2 and from V0 to V3 including: → Peakflow Vmax → Tidal volume (Vt)

    Full Information

    First Posted
    October 15, 2008
    Last Updated
    March 27, 2015
    Sponsor
    Merz Pharmaceuticals GmbH
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00773591
    Brief Title
    Effect of NT 201 (Botulinum Neurotoxin Type A Free of Complexing Proteins) on Sleep-related Breathing Disorders
    Acronym
    Snoring
    Official Title
    Effect of NT 201 (Botulinum Neurotoxin Type A Free of Complexing Proteins) on Sleep-related Breathing Disorders (Snoring Study)
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    March 2015
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    The BfArM (CA)approved the trial in Nov 2008. However, the responsible EC refused approval in March 2009.
    Study Start Date
    March 2010 (undefined)
    Primary Completion Date
    October 2010 (Anticipated)
    Study Completion Date
    October 2010 (Anticipated)

    3. Sponsor/Collaborators

    Name of the Sponsor
    Merz Pharmaceuticals GmbH

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    This proof-of-concept study is to assess the potential benefit of botulinum toxin for patients with sleep-related breathing disorders.
    Detailed Description
    Mono-center, double-blind, 1:1 randomized, placebo-controlled trial 18 treated patients, 9 patients per group. Patients will be randomly assigned to treatment with NT 201 or placebo in a ratio of 1:1. In addition, within each treatment group patients will be randomly assigned to injection into the left or right soft palate. Primary variable: Comparison of the ratio of snoring time over sleeping time (Snoring Index). Other secondary variables will be analysed.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Sleep-Disordered Breathing
    Keywords
    Sleep-related breathing disorders, Snoring

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantInvestigator
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Botulinum Toxin Typ A
    Arm Type
    Active Comparator
    Arm Title
    Placebo
    Arm Type
    Placebo Comparator
    Intervention Type
    Drug
    Intervention Name(s)
    NT 201, a Botulinum neurotoxin type A, free of complexing proteins
    Intervention Description
    NT 201: Solution for injection, one dose of 5 U will be administered. Route Injection into the soft palate 1 cm dorsal to the junction with the hard palate and 1 cm medial to the alveolar ridge. Placebo: Solution for injection, Dose n.a.; identical injected volume as active study medication. Route Injection into the soft palate 1 cm dorsal to the junction with the hard palate and 1 cm medial to the alveolar ridge.
    Primary Outcome Measure Information:
    Title
    Comparison of the ratio of snoring time over sleeping time (Snoring Index)
    Time Frame
    Snoring Index measured from baseline to follow-up visit and to V3.
    Secondary Outcome Measure Information:
    Title
    Change in ventilation (oral/nasal flow) from V0 to V2 and from V0 to V3 including: → Peakflow Vmax → Tidal volume (Vt)
    Time Frame
    Change in several Secondary variables from baseline over time

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Male and female outpatients of at least 18 years of age. Patient who understand the nature of the study and provide written informed consent prior to protocol-specific procedures. Patients suffering from sleep-related breathing disorders for at least 3 months prior to study start and seeking help for their snoring. Non-REM RDI ≤ 25/h (according to Medicare Criteria) at baseline PSG. AHI ≤ 10/h at baseline PSG. Snoring Index ≥ 15 at baseline PSG. Exclusion Criteria: Patients with known hypersensitivity to: botulinum neurotoxin type; any of the excipients (human albumin, sucrose). Patients with upper respiratory tract pathology as assessed by an ear, nose, and throat [ENT] specialist. Patients with generalized disorders of muscle activity (e.g. myasthenia gravis, Lambert-Eaton syndrome). Patients with bleeding disorders of any type and/or receiving anticoagulant therapy. Patients with a profound sleep disorder (pathological number and duration of episodes of hypopnea and apnea), upper airway resistance syndrome [UARS], or obstructive sleep apnea syndrome [OSAS]. Obese patients (BMI ≥ 30). Presence of concomitant diseases: severe or unstable cardiovascular (e.g. severe angina pectoris, post myocardial infarction and ventricular extra systoles), pulmonary, or endocrine disease; clinically relevant renal or hepatic disease or dysfunction; hematological disorder; any other clinically relevant medical condition that could increase the risk to the study participant; malignant disease of any kind during the previous 5 years except for successfully treated skin (basal or squamous cell) cancer; amyotrophic lateral sclerosis or other diseases which result in peripheral neuromuscular dysfunction; risk of developing an angle closure glaucoma; alcohol, drug, or medication abuse within the past year; severe psychiatric or neurological disorders; acute infections of the pharynx. Patients likely to need concomitant medication as follows: 4-aminochinolines; aminoglycosides or spectinomycin, or other medical products interfering with neuromuscular transmission, e.g. tubocurarine-type muscle relaxants; daily psychotropic medication; regular intake or onset of hypnotics, e.g. benzodiazepines, chloralhydrate and combinations, barbiturates (except of mild phytotherapeutics, e.g. valerian, hop and combinations); anti-snoring products during the course of the study such as foams, dental devices. Pregnant or nursing women, or women of childbearing potential who are not using and not willing to continue using a medically reliable method of contraception for the entire study duration, such as oral, injectable, or implantable contraceptives, or intrauterine contraceptive devices, unless they are surgically sterilized/ hysterectomized. Participation in a clinical study within the last 30 days prior to the start of the study. Patients who are employees, relative or spouse of the investigator, of other staff of the investigational site or the sponsor or the CRO. Any donation of germ cells, blood, organs, or bone marrow during the course of the study. Patients who are expected to be non-compliant and/or not cooperative. Patients who are not contractually capable.

    12. IPD Sharing Statement

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    Effect of NT 201 (Botulinum Neurotoxin Type A Free of Complexing Proteins) on Sleep-related Breathing Disorders

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